Pegfilgrastim Induced Aortitis in a Breast Cancer Patient

Background: Aortitis is a term used to describe a group of clinical conditions characterized by inflammatory disorders limited to the aortic wall.It can be classified into infectious and non-infectious causes.Among the non-infectious causes, rheumatological diseases stand out.Other rare etiologies include adverse drug reactions, such as granulocyte colony-stimulating factors (G-CSF).The association is described in 0.3%-0.47% of cases, but with variations in relation to clinical manifestations and therapeutic approach.Case presentation: A 59-year-old woman patient with breast cancer undergoing neoadjuvant chemotherapy with Paclitaxel, Doxorubicin and Cyclophosphamide, associated with Pegfilgrastim (G-CSF) who developed fever, low back pain and dysuria 6 days after taking the medication.Admitted to the hospital on the 5th day of symptoms with nonspecific symptoms and increased inflammatory levels on blood tests and presenting with inflammatory signs in the lower third of the descending thoracic aorta.She carried out etiological investigation, negative for autoimmune and infectious diseases, observed chronological association with the use of medication.Treatment with high dose prednisone was instituted for extended period and Pegfilgrastim was withdrawn in the following chemotherapy cycles.The patient showed clinical and radiological improvement with the instituted therapy.Conclusions: Aortitis is a difficult diagnose condition due to nonspecific manifestations and may be associated with different etiologies.It should be considered in patients undergoing chemotherapy using G-CSF, requiring a high degree of suspicion with prompt withdrawal of G-CSF and therapy instituted.